Individual
DONNA DIVITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 FOUNTAINGROVE PKWY, SANTA ROSA, CA 95403-5720
(707) 566-8600
Mailing address
2169 KINGWOOD RD, ROHNERT PARK, CA 94928-5058
(925) 556-9435
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4614
CA
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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